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Use of NHFOV versus NIPPV for the respiratory support of preterm newborns: a meta-analysis
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  • Li Ming,
  • Zhifeng Wu,
  • Duan Wang,
  • Yong Zhu
Li Ming
Army Medical University Xinqiao Hospital

Corresponding Author:[email protected]

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Zhifeng Wu
Army Medical University Xinqiao Hospital
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Duan Wang
Chongqing Medical University Affiliated Children's Hospital
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Yong Zhu
Department of Pediatric Center University-Town Hospital of Chongqing Medical University 55 Middle University Road Shapingba District Chongqing 401331 China
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Background: Noninvasive ventilation for newborns has become the preferred mode of treatment for respiratory diseases. Objectives: This meta-analysis evaluated and compared the efficacy and safety of noninvasive high-frequency oscillatory ventilation (NHFOV) and nasal intermittent positive-pressure ventilation (NIPPV) for use with newborns. Study design: We searched the PubMed, Cochrane Library, EMBASE, Web of Science,CNKI, Wanfang and VIP databases from inception to April 1, 2022. Randomized controlled trials (RCTs) and cohort studies that evaluated and compared the effectiveness of NHFOV and NIPPV in newborns were included in the review and meta-analysis, which followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Results: Twenty-three articles involving 2,924 patients were included. Compared to NIPPV, NHFOV showed a significantly greater reduction in the intubation rates in initial respiratory support and in the reintubation rate without time limit. While reintubation rates within 72 h and 7 days of post-extubation respiratory support were similar. Significant decreases in the duration of non-invasive ventilation and length of hospital stay were observed with NHOFV, which also: reduced PaCO2 levels, enhanced PaO2 levels and the SpO2/FiO2 ratio at 1 h and 24 h after non-invasive respiratory support; and significantly reduced the risk of bronchopulmonary dysplasia and apnea. Conclusions: Compared to NIPPV, NHFOV is a safer and more effective neonatal respiratory support modality. The potential benefits of NHFOV as a mode of respiratory support for very low birth weight or extremely preterm infants should be investigated in larger trials.